The primary objective of this study is to evaluate uptake and retention of long acting cabotegravir (LA-CAB) also known as Apretude versus daily oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) also known as Truvada for PrEP among high-risk women in metro-Orlando through week 48 (to also include reasons for lack of retention in PrEP care)
This is a 48-week, open-label, single center pharmacist-run study to assess PrEP uptake and persistence among women at high-risk of HIV-1 acquisition in metro-Orlando at a community-based organization called Let's Beehive. All participants in the study will chose whether they want to start IM LA-CAB (with or without the oral lead-in) vs. daily oral TDF/FTC for PrEP. The study will include a Screening Phase (up to 56 days), and an open-label phase (Day 1 up to Week 48). Approximately 50 women defined as "high-risk" for HIV-1 infection who have a confirmed negative HIV test will be enrolled. All insured participants will be responsible for using their insurance plan to obtain coverage for their chosen PrEP medication, in addition to any labs required by the study. This expectation is clearly outlined in the informed consent. The study team will work with participants to minimize their co-pays for study medications and labs through the use of manufacturer and other external assistance programs. For participants who are under-or-uninsured, the study sponsor will provide financial coverage for approximately 20 participants (10 on LA-CAB and 10 on TDF/FTC) to receive PrEP medication and undergo study-required laboratory testing at no cost.
Study Type
OBSERVATIONAL
Enrollment
2
Orlando Immunology Center
Orlando, Florida, United States
Uptake of LA-CAB vs. TDF/FTC for PrEP
proportion of women who initiate LA-CAB vs. TDF/FTC for PrEP
Time frame: 48 weeks
Persistence on LA-CAB vs. TDF/FTC for PrEP
proportion of women who remain on LA-CAB vs. TDF/FTC for PrEP
Time frame: 48 weeks
Persistence on LA-CAB vs. TDF/FTC for PrEP
proportion of women who remain on LA-CAB vs. TDF/FTC for PrEP
Time frame: 24 weeks
Uptake of LA-CAB vs. TDF/FTC for PrEP
proportion of women who initiate LA-CAB vs. TDF/FTC for PrEP
Time frame: 24 weeks
HIV incidence
proportion of women with new HIV infections (will be stratified by intervention group)
Time frame: 24 weeks
HIV incidence
proportion of women with new HIV infections (will be stratified by intervention group)
Time frame: 48 weeks
Awareness of and willingness to initiate PrEP
Proportion of participants who are aware of LA-CAB and daily oral TDF/FTC (based on responses to PrEP awareness and willingness survey)
Time frame: Baseline
Preference for chosen PrEP modality
Proportion of participants who elect to initiate LA-CAB vs. daily oral TDF/FTC for PrEP and reasons why (based on responses to PrEP preference survey)
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Time frame: Baseline and time of PrEP modality switch
Safety and tolerability of LA-CAB vs. TDF/FTC for PrEP
Incidence and severity of AEs and laboratory abnormalities, Investigator assessment of causality of AEs and laboratory abnormalities (drug-relatedness), Proportion of subjects who discontinue PrEP medications due to Aes
Time frame: 24 weeks
Safety and tolerability of LA-CAB vs. TDF/FTC for PrEP
Incidence and severity of AEs and laboratory abnormalities, Investigator assessment of causality of AEs and laboratory abnormalities (drug-relatedness), Proportion of subjects who discontinue PrEP medications due to Aes
Time frame: 48 weeks
PrEP satisfaction
Proportion of participants who are satisfied with their chosen PrEP modality (based on responses to PrEP satisfaction survey)
Time frame: 24 weeks
PrEP satisfaction
Proportion of participants who are satisfied with their chosen PrEP modality (based on responses to PrEP satisfaction survey)
Time frame: 48 weeks
PrEP Adherence
Proportion of participants with 100% adherence (target adherence defined as "within window, on-time LA-CAB injection") to LA-CAB vs. at least 6/7 weekly doses of TDF/FTC
Time frame: 24 weeks
PrEP Adherence
Proportion of participants with 100% adherence (target adherence defined as "within window, on-time LA-CAB injection") to LA-CAB vs. at least 6/7 weekly doses of TDF/FTC
Time frame: 48 weeks
Bacterial STI incidence
Proportion of participants with new STIs (based on proportion with positive results for chlamydia, gonorrhea, trichomonas, and syphilis)
Time frame: 24 weeks
Bacterial STI incidence
Proportion of participants with new STIs (based on proportion with positive results for chlamydia, gonorrhea, trichomonas, and syphilis)
Time frame: 48 weeks
Treatment-emergent resistance among those who acquire HIV infection
Proportion of participants with treatment-emergent resistance associated mutations (RAMs) on LA-CAB vs. daily oral TDF/FTC
Time frame: 24 weeks
Treatment-emergent resistance among those who acquire HIV infection
Proportion of participants with treatment-emergent resistance associated mutations (RAMs) on LA-CAB vs. daily oral TDF/FTC
Time frame: 48 weeks